This project proposes to: 1) evaluate protein requirements and adaptive responses to urinary protein losses in patients with nephrotic syndrome, and 2) to determine whether metabolic acidosis contributes to malnutrition in hemodialysis patients. The first part of the study in nephrotics is nearing completion. Results of 6 patients with chronic renal failure on a very low protein diet demonstrated that the compensatory changes in whole-body protein turnover are sustained during long-term therapy. These results were recently published in the Am J Physiol. Part 2 of the study to evaluate the impact of metabolic acidosis on protein metabolism was revised, and is now a subset of this study (see 327A).